Combatting Antibiotic Resistance in Philippine lakes: One-health upstream interventions to ease the burden

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When antibiotics are used in humans and animals some of the drug may be passed out into urine or faeces, or when delivered in feed and water to animals may run off into the environment. In both cases antibiotics and antibiotic-resistant bacteria may enter water courses such as lakes important as sources of water, for fishing, farming of fish and prawns and for leisure. This contamination may lead to the spread of antibiotic resistance. The development of resistance to key antibiotics is of concern in treating human infections. Fewer restrictions on the use of antibiotics in Asia mean this is a rapidly developing problem both from use in agriculture and medicine.In this project we will assess how antimicrobial use in both humans and animals in Philippines leads to contamination of the large Laguna Lake in Luzon Island. We will then apply physical interventions such as waste water treatment and changes in practice (antimicrobial stewardship) in animals and assess changes to contamination. If successful these approaches can be used in other developing countries sin Asia, Africa and Latin America.